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House Health Care Deal Still Elusive

With time running out to reach consensus before a scheduled summer break, House Democrats appear further than ever from bridging internal rifts on a sweeping health care overhaul.

House Energy and Commerce Chairman Henry Waxman (D-Calif.) spent hours Wednesday in talks with moderate Blue Dog Democrats on his panel who have stalled the package over concerns about its price tag and scope. But the two sides emerged speaking different languages.

Waxman said the Democrats were close to agreement and that he hoped to resume marking up the bill today. Blue Dogs offered a starkly different view, asserting that little progress had been made and that leaders would forge ahead at their own peril.

“If they’re going to take this thing forward, I don’t see any reason why we need to continue to meet,— said Rep. Charlie Melancon (D-La.), a Blue Dog leader and panel member. He said the only thing Blue Dogs agreed to was “that nothing would be done until everything was agreed on, and apparently that’s not to the liking of some of the people in leadership.—

Adding to Blue Dog frustration was a claim earlier in the day by Speaker Nancy Pelosi (D-Calif.) that she has the votes to pass the bill in the chamber.“I have no question that we have the votes on the floor of the House to pass this legislation,— she said at a midday press conference. Pelosi said she still intends to put the package to a vote next week while leaving open the possibility of keeping the House in session past the end of the week, if necessary.

Taken together, the Waxman and Pelosi statements were interpreted as signals of bad faith by some Blue Dogs, who are nursing a gripe that they were shut out of the bill-writing on the health care package.


The 52-member bloc has been rallying to stay united in its campaign to moderate the health care package. If the Blue Dogs hang together, they can keep the bill from passing — a fact several pointed to as they dismissed Pelosi’s assertion that she has the votes she needs.

“I think the Speaker was well-intended, because she was hearing optimistic things, but I don’t think she has the votes right now,— said Rep. Baron Hill (D-Ind.), another Blue Dog leader participating in the negotiations with Waxman.

Melancon agreed, saying if leaders bring the bill to the floor, “we’re going to need some orthopedists around here to take care of the broken bones and twisted arms.—

The new signs of trouble came a day after Blue Dogs reached a significant breakthrough with Waxman in a White House meeting with President Barack Obama. In that Tuesday huddle, Waxman agreed to an independent commission to control Medicare spending, an idea Obama proposed but House chairmen originally rejected.

Blue Dogs touted it as a major boon to cutting health care expenditures. But after their meeting with Waxman on Wednesday, negotiators said they had yet to nail down specifics of the proposal.

“The administration feels that this is a game-changer that will hold down costs for the future,— Waxman told reporters. “We’ve done everything else we can think of to accomplish that goal.—

The idea is modeled roughly on the base-closing-commission legislation, where a commission presents a package of cuts to the president and Congress, followed by an up-or-down vote.

But the idea is controversial among other Democrats, with a number of them uncomfortable with — or downright opposed to — the idea of giving an unelected commission such power.

“I’m against it,— said Rep. Richard Neal (D-Mass.), a subcommittee chairman on the Ways and Means Committee, which shares jurisdiction over parts of Medicare with Energy and Commerce. “I think it’s an adoption of the line-item veto— and a shirking of Congress’ responsibility, Neal said.

For Blue Dogs, the idea is only the first on a list of 10 concerns they want addressed in the bill, including fixing regional disparities in Medicare reimbursements, expanding an exemption for small businesses from an employer insurance mandate, and ensuring that a government-run insurance option not be tied to Medicare rates.

“This bill is the most important piece of legislation in this generation, I believe,— Melancon said. “So why are we rushing it? Let’s get it right. The president said he wanted something by the end of the year. He didn’t say he wanted it by the August break. I wish they’d listen.—

In a bit of cognitive dissonance, moments after Melancon made his remarks, Pelosi was praising Blue Dogs for their commitment to fiscal responsibility at a press conference to tout the passage of pay-as-you-go legislation.

Steven T. Dennis contributed to this report.

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